Some therapeutic EUS procedures require multiple steps and exchanges and are technically demanding. Dedicated devices are desirable to improve reproducibility and safety. FNA needles, borrowed from tissue acquisition, are usually used for transmural access. In our case, an 84-year-old woman was referred for jaundice due to lymphoma-related lymphadenopathies. ERCP was not feasible due to duodenal infiltration; EUS-guided hepaticogastrostomy was performed using a new dedicated access needle system (SonoTip AccessPro, Medi-Globe, Germany). In the video, we describe limitations related to FNA needles, present the main features and potential advantages of the new needle system, and illustrate all procedural steps. In our case, guidewire manipulation was particularly challenging, with many back-and-forth movements required; the blunt-tipped cannula allowed smooth manipulation without shearing.